EDITORIAL: Put patients first in the fight over the closing of Westlake Hospital

At the heart of the debate over closing Westlake Hospital in Melrose Park is a simple question: Is the 230-bed facility crucial to maintaining quality medical care in the near west suburbs?

All other considerations, including whether the hospital’s new owners have been true to their word and the economic impact on Melrose Park, are secondary.

Ultimately, it will be a state agency or the courts that provide the most unbiased answer. We’re on the side of keeping the hospital open at least until that basic determination — the impact on community health care — is made.

In January, California-based Pipeline Health and TWG Partners bought Westlake and two other Chicago area hospitals for $70 million. The new owners made a point of saying the three hospitals would remain open.

“We’re not put out by the fact that these hospitals have some issues and problems from a financial perspective,” Pipeline’s CEO, Jim Edwards, told the Chicago Tribune at the time. “We feel strongly with our resources, our finances, our experience we can come in and make a difference, and, for lack of a better way to put it, save these hospitals.”

But just weeks later, Pipeline announced it would close Westlake because it was losing too much money. And last week, Pipeline said that because of low staffing levels it would start the closing process earlier than expected. A medical office building on the hospital campus would remain open.

The village of Melrose Park sued, claiming Pipeline had promised to keep Westlake open for at least two years. The village secured a temporary restraining order, later reinstated by the Illinois Supreme Court through May 1, to keep Pipeline from reducing services, and a judge criticized the health care company for violating the order by removing equipment from the hospital.

On Monday, the Cook County state’s attorney joined the village as a plaintiff.

In its application to close Westlake, Pipeline said, “The discontinuation of services at Westlake will have no known adverse impact on essential safety net services to the community.”

But, with all respect to the folks at Pipeline, it’s in their interest to say that.

Melrose Park officials and other champions of the hospital beg to differ. They say closing Westlake would punch a big hole in the safety net for hospital care in the near west suburbs.

On April 30, the Illinois Health Facilities and Services Review Board will consider Pipeline’s application to shut down the hospital. If Pipeline’s application for a “certificate of exemption” is in order, the board can’t deny its application, but it could — as called for in its rules — postpone a decision while litigation is pending.

If this sounds as complicated as open-heart surgery, that’s because it is. But just as with surgery, the only outcome that really matters is quality health care. Not money or even local economic development.

Melrose Park fears losing a big community anchor, with its 600 or so jobs and the boost it gives to nearby businesses. We appreciate that. It’s not unlike why many Chicago neighborhoods fear the closing of a school, which can be a vital social and economic anchor.

Pipeline, for its part, would rather earn larger profits than smaller ones, but has been operating Westlake at a net loss. Dr. Eric Whitaker, the founder of TWG partners and a close friend of former President Barack Obama, said Westlake lost $14 million last year.

Westlake’s financial problems have been driven in part by a national trend toward less in-patient care and more out-patient care, which has created a surplus of empty hospital beds. Some Chicago area hospitals are less than 50 percent occupied.

At Westlake, the number of in-patient admissions declined nearly 13 percent from 2016 to 2018, Pipeline said in its application to shut down the hospital.

But in addition to national trends that threaten the bottom line of hospitals, Westlake has been hurt by practices particular to Illinois. Westlake has a large number of Medicaid patients, but Illinois ranks 50th among the states — dead last — in Medicaid reimbursement per patient. On top of that, because of Illinois’ budgetary problems, the state has been extremely slow to pay those reimbursements.

Pipeline says an unrelated change in state law last year, providing for more funding to “safety-net” hospitals that treat a large portion of Medicaid payments, excluded Westlake in this category, costing the hospital an additional $4 million a year. The Legislature should reconsider whether its definition of a safety-net hospital is fair or too narrowly drawn.

If Westlake closes, its patients will need to go to other hospitals. Many of those patients, though, are in one of the three Medicaid-managed care networks that serve Cook County. Those networks will have to find replacement hospitals for their patients.

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The Illinois Health Facilities and Services Review Board was set up to decide whether new hospitals or programs are needed in particular areas. It wasn’t designed to determine whether it makes medical sense to close a hospital. But if the courts don’t act, it should do just that.

Somebody has to decide whether Westlake is vital to the provision of health care in the community — and it shouldn’t be Pipeline.

Legislation proposed in Springfield would give the governor the authority to overrule a decision by the review board to allow a hospital to close. But, here again, that decision should be based on medical need, not politics.

What matters most is that the patient come first.

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